Women have lower rates of substance use and dependence than men. However, being a nurse is thought to put women at increased risk of substance use and thereby at increased risk of dependence syndromes, such that risks for some female nurses approach or exceed the levels of risk experienced by men. The major goal of this project is to assess the effect of membership in the nursing profession on substance use. Specifically, this research will: 1. examine the association among access to substances, freedom from negative proscriptions toward substance use, role strain, and substance use among registered nurses. 2. assess whether nurses' working conditions function as an effect modifier of the above relationships. 3. identify clinical specialty groups within the nursing profession which are at higher risk of substance use than their peers. 4. relate the level of access to specific substances within identified high-risk nursing specialties to the use of those substances. 5. compare substance use among nurses to a sample of non-nurses, with adjustment for hours worked and level of education. To accomplish the above aims, an anonymous mailed survey of substance use among 6,000 registered nurses will be conducted, using a multi-stage stratified probability sample of registered nurses in the U.S. also included will be a control group of non-nurses obtained from the National Household Survey on Drug Abuse. This will allow us to place nurses' substance use into a context with other women and other professionals, so that we can identify any risks of substance use specific to the nursing profession. Analyses will be conducted using multiple logistic regression. The identification of nursing specialties at high-risk for substance abuse will improve the design of educational and preventive initiatives which address substance use among registered nurses, as well as among other vulnerable female populations.